Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Mar 21, 2018
License(s)
5501013478 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 33693 STONECREST DR | Sterling Heights, MI 48312-5786 | 586-354-8139 |
| LOCATION | 33300 UTICA RD | Fraser, MI 48026-2017 | 586-354-8139 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.